Key result
DOACs show noninferiority to LMWH for recurrent events and major bleeding in cancer-associated VTE.
Why the study?
Anticoagulation for cancer-associated VTE is challenging with VKAs and LMWH, and until recently there were no large clinical trials assessing DOAC efficacy and safety in cancer patients.
Do direct oral anticoagulants (DOACs) reduce recurrent VTE and major bleeding compared to low-molecular-weight heparin (LMWH) in patients with cancer-associated venous thromboembolism?
Population
Patients with cancer-associated VTE
Comparison
DOACs vs LMWH
Design
Review
Authors
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DOACs may ease anticoagulation in cancer VTE; leaves open optimal agent selection and bleeding risks pending dedicated trials.
Do direct oral anticoagulants (DOACs) reduce recurrent VTE and major bleeding compared to low-molecular-weight heparin (LMWH) in patients with cancer-associated venous thromboembolism?
Absolute Event Rate: 12.8% vs 13.5%
DOACs are a reasonable alternative to LMWH for treating cancer-associated VTE, though they should be used with caution in patients with gastrointestinal cancers due to an increased risk of bleeding.
Ay et al. (2019) conducted a review in cancer-associated venous thromboembolism. Direct oral anticoagulants (DOACs) vs. low-molecular-weight heparin (LMWH) was evaluated on composite of recurrent VTE and major bleeding. Direct oral anticoagulants appear to be reasonable alternatives to LMWH for cancer-associated VTE, with edoxaban showing noninferiority to dalteparin for recurrent VTE and major bleeding (12.8% vs 13.5%).
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